Research Profile - When history makes you sick

A multi-year, CIHR-funded study that partners university researchers with Aboriginal leaders has proven that children of survivors of residential school abuse can face a higher risk for contracting Hepatitis C.

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In what they believe is a world first, researchers at the University of British Columbia – working directly with Aboriginal leaders, community groups and health care providers – have produced evidence linking historical trauma to an increased risk for disease.

Over the past six years, the Cedar Project has engaged a group of Aboriginal young people in Vancouver and Prince George who smoke or inject illicit drugs. The researchers have shown that the likelihood of contracting Hepatitis C is almost two times greater for those with a parent who attended residential schools.

Media reports of the findings – which were released in February during the Winter Olympics – noted that while high rates of drug use and Hepatitis C infection came as no surprise for the mean streets of Vancouver's Downtown Eastside, the rates were actually higher for Prince George, a city of about 70,000 in interior British Columbia.

The study ranked historical trauma as tied for third – alongside being female – as the most serious risk factor for Hepatitis C for the study's participants. Daily intravenous drug use and reusing needles were the number one and two risk factors.

"We've looked everywhere around the world in places where there were residential schools – New Zealand, Australia, the United States and Canada," says Dr. Patricia Spittal, an Associate Professor at UBC's School of Population and Public Health. "It's the first time that we know of that the residential school history has been linked statistically to infectious disease."

According to Dr. Spitttal, it's no stretch to link higher incidence of Hepatitis C – a liver infection spread by blood-to-blood contact – with use of injected drugs. Nor is it hard to understand why the sons and daughters of residential school survivors, many of whom have also experienced abuse or were removed from their families in early childhood – might be drawn into a life that includes reliance on drugs.

"It's self-medication," says Dr. Spittal. "Almost half of the young people in our studies have had an early childhood sexual abuse experience. As well, about 60% of the young people involved in our study were taken away from their parents, with the median age of the first foster care experience being five years old. So it's an intergenerational trauma issue. You go through everything, and then you want to numb your pain."

The Cedar Project, which receives much of its funding from the Canadian Institutes of Health Research, is a collaborative, community-based research initiative that involves Aboriginal and non-Aboriginal researchers working with Aboriginal leaders.

Chief Wayne Christian of the Splatsin Secwepemc Nation co-authored the report, one of several the Cedar Project has produced. He says it provides strong evidence for the need to create "healing environments" for at-risk Aboriginal people to address the multigenerational trauma that has resulted from years of abuse in residential schools.

"Our people have used psychotherapy and a number of different processes," says Chief Christian. "But also there are our traditional methods. The cleansing of a sweat lodge ceremony is what some people use along with different ceremonies with water and bathing. There's a whole other array of tools. I call them human resource tools; they come out of our culture and need to be combined with modern-day tools to give people what they need in terms of their healing."

Dr. Spittal sees the researchers' role as helping to address the health concerns arising from the historical trauma that residential schools inflicted on Aboriginal people. And while the rates of HIV and Hepatitis C infection among First Nations, Inuit and Métis populations in Canada are regarded as epidemic, she sees considerable hope in the future.

"We're trying to understand the drivers of the epidemic, one of which is historical trauma. But it's never bleak, because the energy and the wisdom offered Aboriginal leadership is amazing. They are determined to find their own solutions that can bridge both Western and indigenous healing systems regarding the kinds of things that need to happen."

"Those numbers represent our people. It could be our nieces, nephews, or grandchildren. It could be siblings; it could be aunties, uncles. So for us when we speak of those statistics, to us it's more than a number. That's why we're so engaged in this process – because it means a lot to us in terms of what we are doing for our youth."
-- Chief Wayne Christian

The Study

The Cedar Project is named after the evergreen traditionally used in Aboriginal peoples' rituals as a smudge or brush to cleanse and purify. It is also regarded as a "the tree of life" for its ability to withstand the four elements throughout the seasons.

The project is investigating the high rates of HIV and Hepatitis C infection among Aboriginal people. Young people – especially those who take illicit drugs – are particularly at risk. A research theme is the relationship between having a parent or grandparent who attended residential school or being in the child welfare system and vulnerability to HIV and hepatitis C infection.

Funded mainly by CIHR, the longitudinal study has followed about 600 at-risk Aboriginal people – aged 14 to 30 years – in Vancouver and Prince George since 2003. The project is expanding to include at-risk Aboriginal young people in Kamloops. Dr. Spittal expects the cohort to increase to 1,000 and studies to carry on for several more years.

For more information visit the Cedar Project website.